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Comparison of Refractive Error Changes in Retinopathy of Prematurity Patients Treated with Diode and Red Lasers
Ramak Roohipoor1, Reza Karkhaneh, Mohammad Riazi Esfahani
1Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Red laser treatment for retinopathy of prematurity (ROP) resulted in less myopic shift compared to diode laser. Zone I ROP showed a greater myopic shift, regardless of laser type.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Laser Therapy
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Laser photocoagulation is a standard treatment for ROP, but refractive outcomes can vary.
- Understanding refractive error changes post-treatment is crucial for long-term visual prognosis.
Purpose of the Study:
- To compare refractive error changes in retinopathy of prematurity (ROP) patients treated with diode versus red laser therapy.
- To identify factors influencing refractive outcomes after laser treatment for ROP.
Main Methods:
- A randomized, double-masked clinical trial involving infants with threshold or prethreshold ROP.
- Patients were assigned to receive either red or diode laser treatment.
- Refractive errors were assessed at 12 months corrected age, with data on gestational age, birth weight, and disease characteristics recorded.
Main Results:
- 150 eyes from 75 infants were analyzed (74 diode, 76 red laser).
- Post-treatment, a significant myopic shift was observed in both groups (p < 0.001).
- Diode laser treatment for zone I ROP showed the greatest myopic shift (mean 6.00 dpt), while red laser for zone II showed the least (mean 1.12 dpt).
Conclusions:
- The type of laser used and the zone of ROP involvement significantly impact refractive error changes.
- Red laser therapy appears to induce less myopic shift compared to diode laser.
- Zone I ROP is associated with a greater myopic shift than zone II ROP after laser treatment.
Aim:
To compare refractive error changes in retinopathy of prematurity (ROP) patients treated with diode and red lasers.
Methods:
A randomized double-masked clinical trial was performed, and infants with threshold or prethreshold type 1 ROP were assigned to red or diode laser groups. Gestational age, birth weight, pretreatment cycloplegic refraction, time of treatment, disease stage, zone and disease severity were recorded. Patients received either red or diode laser treatment and were regularly followed up for retina assessment and refraction. The information at month 12 of corrected age was considered for comparison.
Results:
One hundred and fifty eyes of 75 infants were enrolled in the study. Seventy-four eyes received diode and 76 red laser therapy. The mean gestational age and birth weight of the infants were 28.6 ± 3.2 weeks and 1,441 ± 491 g, respectively. The mean baseline refractive error was +2.3 ± 1.7 dpt. Posttreatment refraction showed a significant myopic shift (mean 2.6 ± 2.0 dpt) with significant difference between the two groups (p < 0.001). There was a greater myopic shift among children with zone I and diode laser treatment (mean 6.00 dpt) and a lesser shift among children with zone II and red laser treatment (mean 1.12 dpt). The linear regression model, using the generalized estimating equation method, showed that the type of laser used has a significant effect on myopic shift even after adjustment for other variables.
Conclusion:
Myopic shift in laser-treated ROP patients is related to the type of laser used and the involved zone. Red laser seems to cause less myopic shift than diode laser, and those with zone I involvement have a greater myopic shift than those with ROP in zone II.
